| Objective: Focal cortical dysplasia(FCD)represents a specific malformation of cortical development and is one of the most common causes of refractory epilepsy.The purpose of our study was to investigate the effects of surgical intervention of FCD ?a on epilepsy outcome and to evaluate the prognostic factors of seizure freedom.Methods: We retrospectively reviewed patient data from epilepsy surgeries at the second affiliated hospital of Dalian medical university between 2007 and 2015.110 patients with the definite pathological diagnosis of FCD ?a were included in the study.They all underwent presurgical evaluation and postoperative follow-up(?1 year)treatment.In this retrospective clinical study,the clinical characteristics,seizure outcome,and quality of life in adults with FCD ?a were evaluated.Seizure recurrence was any postoperative disabling seizure(complex partial seizure [CPS] ± secondary generalization).Multivariate Cox proportional hazards regression models examined potential preoperative and perioperative risk factors of the seizure recurrence.The probability of remaining free of disabling seizures was calculated using Kaplan-Meier survival analysis.Quality Of Life in Epilepsy scale(QOLIE-10)was used to assess life quality of our patients.Results: The Engel seizure outcome achievements were class I in 72(65.4 %),class ? in 20(18.2 %),class ? in 11(10 %),and class ? in 7(6.4 %)patients.Engel seizureoutcome was relevant with the resection range of the lesions(P=0.028),an complete surgical resection in the patients may lead to a positive operation efficacy.The morphology of interictal discharges on scalp EEG were divided into 4 types,including spikes,multiple-spikes,fast rhythms and spine-slow waves.Meanwhile the spikes,multiple-spikes and spine-slow waves were significantly reduced after the surgery(P=0.000).The assessments of ECo G patterns and MRI are relevant to determine the extent of the resection which can influence the surgery outcome(P=0.001,0.023).By multivariate regression analyses,in epilepsy patients with FCD ?a,extent of resection,seizure frequency,preoperative ECo G and location of resection were the most important risk factors for seizure recurrence.The results of QOLIE-10 showed that the preoperative total scores of the 110 patients were significantly higher than that 1 year after the surgery,and the quality of life were improved significantly(P=0.000).Conclusion: Surgical intervention,Eco G and MRI positioning and complete resection of the lesion help for a better seizure control,relief of anxiety,and quality of life.The epileptiform waves decreased significantly.All these findings strongly suggest early consideration of epilepsy surgery in FCD?a patients. |
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